Coeliac disease

About coeliac disease 

Coeliac disease is caused by an adverse reaction by the immune system to gluten. Gluten is a dietary protein found in three types of cereal:

• wheat
• barley
• rye

Gluten is found in any food that contains the above cereals, including:

• pasta
• cakes
• breakfast cereals
• most types of bread
• certain types of sauces
• some types of ready meals

In addition, most beers are made from barley.

Symptoms of coeliac disease 

Eating foods containing gluten can trigger a range of gut-related symptoms, such as:

• diarrhoea, which may smell particularly unpleasant
• abdominal pain
• bloating and flatulence (passing wind)
• indigestion 
• constipation

Coeliac disease can also cause a number of more general symptoms, including:

• fatigue as a result of malnutrition (not getting enough nutrients from food) 
• unexpected weight loss 
• an itchy rash (dermatitis herpetiformis)
• problems getting pregnant 
• nerve damage (peripheral neuropathy)
• disorders that affect co-ordination, balance and speech (ataxia)

Children with coeliac disease may not grow at the expected rate and may have delayed puberty. 

Causes of coeliac disease 

Coeliac disease is an autoimmune condition. This is where the immune system – the body's defence against infection – mistakenly attacks healthy tissue.

In coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them.

It's not entirely clear what causes the immune system to act in this way. But a combination of genetics and the environment appear to play a part.

Coeliac disease isn't an allergy or an intolerance to gluten.

Treating coeliac disease 

There's no cure for coeliac disease. Switching to a gluten-free diet should help control symptoms and prevent the long-term consequences of the condition.

Even if you have no symptoms, or mild symptoms, changing your diet is still recommended. This is because continuing to eat gluten can lead to serious complications.

It's important to make sure that your gluten-free diet is healthy and balanced, see help and support below.

Complications of coeliac disease 

Complications of coeliac disease only tend to affect people who continue to eat gluten, or those who've yet to be diagnosed with the condition, which can be a common problem in milder cases.

Potential long-term complications include:

• osteoporosis (weakening of the bones)
• iron deficiency anaemia
• vitamin B12 and folate deficiency anaemia 

Less common and more serious complications include those affecting pregnancy, such as having a low-birth weight baby, and some types of cancers, such as bowel cancer.

Who's affected 

Coeliac disease is a common condition. In the UK, about one in every hundred people has the condition.

Reported cases of coeliac disease are two to three times higher in women than men. It can develop at any age.  People with certain conditions, including type 1 diabetes, autoimmune thyroid disease, have an increased risk of getting coeliac disease.

Relatives (parents, brothers, sisters and children) of people with coeliac disease are also at increased risk of developing the condition.

Diagnosing coeliac disease 

Routine testing for coeliac disease isn't recommended unless you have symptoms or an increased risk of developing them.

Testing for coeliac disease involves having:

• blood tests – to help identify people who may have coeliac disease
• a biopsy – to confirm the diagnosis

While being tested for coeliac disease, you'll need to eat foods containing gluten to make sure the tests are accurate.

You should also not start a gluten-free diet until the diagnosis is confirmed by a specialist, even if the results of blood tests are positive.

Help and support 

Coeliac UK is a charity for people with coeliac disease.

Its website contains a range of useful resources, including information about the gluten-free diet, as well as the details of local groups, volunteering and ongoing campaigns.

• Find out more about coeliac disease on the NHS website

More useful links

• How to use your health services